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Is liver disease worse where you live?
Liver disease death rates differ sharply from state to state, but a state’s number describes a whole population, not you.
What state liver numbers show
In CDC’s 2024 figures, New Mexico’s age-adjusted chronic liver disease and cirrhosis death rate was 31.1 per 100,000 people, while New York’s was 7.3. That is more than four times higher.
If you’re here after a lab result
Curious about your state? See the tables below.
Worried about a flagged ALT? Start with what your ALT blood test number means, because a lab value says more about you than a state average.
ℹ️ Medical Disclaimer: This article is general education about population statistics. It does not diagnose liver disease or recommend any treatment, medication, alcohol limit, test, procedure or insurance decision, and a state death rate is not a personal risk score. Consult a primary care clinician or hepatologist (liver specialist) before acting on any liver concern, and call emergency services in an emergency.
Which states have the highest liver disease death rates?
New Mexico had the highest age-adjusted chronic liver disease and cirrhosis death rate in CDC’s 2024 data, at 31.1 deaths per 100,000 population.
Top five states in CDC’s 2024 data
| State | Rate per 100,000 | Deaths | Key Clinical Detail |
|---|---|---|---|
| New Mexico | 31.1 | 742 | Highest rate and highest count of the five |
| South Dakota | 27.3 | 261 | Second highest |
| Wyoming | 21.6 | 148 | Fewer deaths, so rank is less stable |
| Montana | 19.0 | 251 | Fourth highest |
| North Dakota | 17.8 | 147 | Fewer deaths, so rank is less stable |
Find your own state in CDC’s state-by-state liver disease mortality table.
Lowest five, and the District of Columbia
New York, at 7.3, is the lowest state. The District of Columbia (6.7) is lower but is not a state.
| State | Rate per 100,000 | Deaths | Key Clinical Detail |
|---|---|---|---|
| District of Columbia | 6.7 | 49 | Not a state |
| New York | 7.3 | 1,801 | Lowest of the 50 states |
| Hawaii | 7.5 | 144 | Fewer deaths, so rank is less stable |
| New Jersey | 7.9 | 924 | Fourth lowest, counting DC |
| Maryland | 8.6 | 659 | Fifth lowest, counting DC |
Source (both tables): CDC NCHS Stats of the States, 2024 data, age-adjusted deaths per 100,000 population. Values were retrieved through Becker’s Hospital Review (Aug 7, 2026), which reports CDC’s figures.
Why small-state rankings can shift
CDC cautions that when deaths are few, state differences and rankings may be unreliable. Wyoming’s 148 deaths are far fewer than New Mexico’s 742, so treat close small-state ranks as approximate.
What does a liver disease death rate actually measure?
An age-adjusted death rate is the number of deaths per 100,000 residents, adjusted so states with older or younger populations can be compared fairly. CDC defines the rate per 100,000 total population and notes that state differences do not account for other state characteristics.
Age-adjusted rate per 100,000 population
🔬 How It Works: Age adjustment accounts for how old each state’s residents are, so a state is not ranked worse only because its population is older.
Chronic liver disease versus cirrhosis in the data
CDC’s category combines chronic liver disease and cirrhosis. NCHS counts ICD-10 codes K70, K73 and K74 as cirrhosis; NIAAA’s liver cirrhosis mortality surveillance report adds K76.0 and K76.6, so its numbers run slightly larger.
What death statistics can undercount
Death certificates have historically undercounted chronic liver disease, and NIAAA says alcohol involvement may be under-recorded.
Why do liver death rates differ between states?
US cirrhosis deaths have climbed: the age-adjusted rate rose from 9.7 per 100,000 in 2000 to 14.1 in 2023, peaking at 15.5 in 2021 (NIAAA).
Alcohol and the rise in cirrhosis deaths
📊 Clinical Data Point: In 2023, 50.3% of US cirrhosis deaths (28,632 of 56,975) were coded alcohol-related. — Source: NIAAA Surveillance Report #123, Sept 2025.
Viral hepatitis, income and ethnicity: what a 2010 study found
A 2018 American Journal of Medicine analysis of state liver death rates found that, in 2010 data, higher state rates were associated with a larger Hispanic population (r = 0.538), lower household income (r = 0.405) and more viral hepatitis deaths (r about 0.55); the study could not say why. See ALT levels in hepatitis C.
What state data can’t explain
The same study found no significant link with self-reported drinking or obesity, though NIAAA codes about half of cirrhosis deaths as alcohol-related. A state survey measures averages, not who drinks heavily. These are correlations, not causes.
Where does fatty liver disease fit into the picture?
Fatty liver disease is common, but state death data do not measure it.
MASLD, NAFLD and MASH: same disease, newer names
NIDDK’s overview of fatty liver disease describes NAFLD, also called MASLD, as fat buildup in the liver not caused by heavy alcohol use. About 24% of US adults have it and about 1.5% to 6.5% have NASH, the inflamed form (NIDDK, April 2021).
How fatty liver can progress
🔬 How It Works: In NASH, inflammation can scar the liver (fibrosis), which may lead to cirrhosis. Most people with fatty liver do not have NASH.
For the ALT side of this, see what a high ALT can mean with fatty liver.
✅ Patient Action: NIDDK links fatty liver to obesity and type 2 diabetes. If either applies, ask a primary care clinician or hepatologist: “Given my metabolic risk factors, should my liver be assessed?”
Does your state’s rate change your own liver risk?
Your state’s rate describes a population, not your liver.
Why a state average isn’t your risk
A high-rate state does not doom you, and a low-rate state does not protect you.
County and access differences inside one state
A 2021 Gastroenterology study of CDC WONDER data (2009–2018) found county liver death rates differed significantly within states. Demographics, poverty, insurance, transplant-center distance, and local obesity, diabetes and alcohol use explained 61% of county variation.
Three questions to ask yourself
NIDDK lists alcohol-associated liver disease, fatty liver disease and chronic hepatitis B or C as leading causes of cirrhosis:
- Do I drink alcohol regularly?
- Have I ever been tested for hepatitis B or C?
- Do I have type 2 diabetes or obesity? Our BMI calculator can help you check.
A yes prompts a clinician conversation, not a diagnosis.
✅ Patient Action: Ask a primary care clinician: “Which liver tests or screening fit my risk factors?”
When to see a doctor about liver symptoms
Early cirrhosis may cause no symptoms; they may not appear until the liver is badly damaged.
Early signs that are easy to miss
NIDDK’s list of cirrhosis symptoms and causes includes tiredness, itching, poor appetite, unintended weight loss, nausea and upper-right abdominal discomfort.
Signs that need prompt medical care
NIDDK also lists yellow skin and eyes (jaundice), darker urine, leg or belly swelling from fluid (ascites), easy bruising or bleeding, and confusion. Contact a clinician promptly for these.
⚠️ Clinical Warning: Call emergency services if someone is confused, very drowsy or bleeding heavily. This is general safety guidance, not an NIDDK threshold.
✅ Patient Action: Ask a primary care clinician or hepatologist: “Could my symptoms and risk factors warrant liver blood tests?” Our questions to ask your doctor about liver enzymes help you prepare.
Liver disease by state: common questions
1. Which state has the highest liver disease death rate?
New Mexico had the highest liver disease death rate by state in CDC’s 2024 data: 31.1 deaths per 100,000 population, age-adjusted.
2. Which state has the lowest liver disease death rate?
New York’s 7.3 per 100,000 is the lowest state liver disease death rate; DC, not a state, is lower at 6.7.
3. What does age-adjusted death rate mean?
An age-adjusted liver disease death rate counts deaths per 100,000 residents, adjusted for age so states with different populations compare fairly.
4. Is chronic liver disease the same as cirrhosis in state data?
Not exactly. CDC’s category covers chronic liver disease and cirrhosis, and NIAAA’s cirrhosis count uses a slightly broader code set.
5. Are liver disease deaths rising in the US?
Liver deaths from cirrhosis are rising: the age-adjusted rate went from 9.7 per 100,000 in 2000 to 14.1 in 2023.
6. How many cirrhosis deaths involve alcohol?
In 2023, 50.3% of US cirrhosis deaths were coded alcohol-related, though NIAAA says alcohol involvement may be under-recorded.
7. Does alcohol use explain why liver disease rates differ by state?
Not by itself: a 2010 state analysis found no significant link with state drinking surveys, while income, ethnicity and viral hepatitis were associated.
8. Does fatty liver disease cause cirrhosis?
Fatty liver disease can progress through NASH to cirrhosis, but about 1.5% to 6.5% of adults have NASH. Ask a hepatologist about your risk.
9. Does living in a high-rate state raise my personal liver risk?
A state rate describes a population, and county rates vary within states. Ask a primary care clinician which liver tests fit you.
10. Can you have liver disease without symptoms?
Yes. Early liver disease can be silent: NIDDK says earliest-stage cirrhosis may cause no symptoms. Ask a primary care clinician about liver blood tests.
11. When should I see a doctor about liver symptoms?
For liver symptoms like yellow skin or eyes, dark urine or swelling, contact a clinician; call emergency services for confusion or heavy bleeding.
What to take from your state’s liver numbers
State numbers describe groups, not you. Your own risk factors and lab results are a better starting point. Bring your ALT value and your answers to the three questions above to a primary care clinician, and ask which liver tests fit you.
About this content
How this article was put together: researched from recognised health sources, drafted with the help of AI tools, and edited by hand, with sources linked throughout.
Sameer Patel is the founder and editor of My Medicine Advisor. He is not a doctor or medical professional — before starting this site he worked in banking,…
Medical disclaimer
The content on MyMedicineAdvisor is provided for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Health information on this website should not be used to diagnose, treat, cure, or prevent any condition without guidance from a qualified healthcare professional. Always seek the advice of your doctor, physician, or another licensed healthcare provider with any questions you may have regarding a medical condition, symptoms, medications, or treatment decisions.
